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Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT).
JAMA Oncol 2015; 1(3):342-9JO

Abstract

IMPORTANCE

African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men.

OBJECTIVE

To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race.

DESIGN, SETTING, AND PARTICIPANTS

Prospective study of 3398 African American and 22,673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001-2011) with present analyses completed in 2014.

MAIN OUTCOMES AND MEASURES

Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence.

RESULTS

With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, <25 vs ≥35: hazard ratio [HR], 1.49 [95% CI, 0.95, 2.34]; P for trend = .03). Consequently, the risk associated with African American race increased from 28% (HR, 1.28 [95% CI, 0.91-1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38-2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, <25 vs ≥35: HR, 0.80 [95% CI, 0.58-1.09]; P for trend = .02) but positively associated with risk within African American men (BMI, <25 vs ≥35: HR, 2.22 [95% CI, 1.17-4.21]; P for trend = .05). Body mass index was positively associated with risk of high-grade prostate cancer in both non-Hispanic white men (BMI, <25 vs ≥35: HR, 1.33 [95% CI, 0.90-1.97]; P for trend = .01) and African American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, <25 vs ≥35: HR, 1.81 [95% CI, 0.79-4.11]; P for trend = .02).

CONCLUSIONS AND RELEVANCE

Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.

Authors+Show Affiliations

Department of Psychosocial and Community Health, University of Washington, Seattle2Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle3Department of Epidemiology, University of Washington, Seattle.Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle.Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle3Department of Epidemiology, University of Washington, Seattle.SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle.Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle.Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio.University of Colorado Denver School of Medicine, Aurora, Colorado.Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle3Department of Epidemiology, University of Washington, Seattle.

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26181184

Citation

Barrington, Wendy E., et al. "Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT)." JAMA Oncology, vol. 1, no. 3, 2015, pp. 342-9.
Barrington WE, Schenk JM, Etzioni R, et al. Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA Oncol. 2015;1(3):342-9.
Barrington, W. E., Schenk, J. M., Etzioni, R., Arnold, K. B., Neuhouser, M. L., Thompson, I. M., ... Kristal, A. R. (2015). Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA Oncology, 1(3), pp. 342-9. doi:10.1001/jamaoncol.2015.0513.
Barrington WE, et al. Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA Oncol. 2015;1(3):342-9. PubMed PMID: 26181184.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT). AU - Barrington,Wendy E, AU - Schenk,Jeannette M, AU - Etzioni,Ruth, AU - Arnold,Kathryn B, AU - Neuhouser,Marian L, AU - Thompson,Ian M,Jr AU - Lucia,M Scott, AU - Kristal,Alan R, PY - 2015/7/17/entrez PY - 2015/7/17/pubmed PY - 2016/3/30/medline SP - 342 EP - 9 JF - JAMA oncology JO - JAMA Oncol VL - 1 IS - 3 N2 - IMPORTANCE: African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men. OBJECTIVE: To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of 3398 African American and 22,673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001-2011) with present analyses completed in 2014. MAIN OUTCOMES AND MEASURES: Total, low-grade (Gleason score <7), and high-grade (Gleason score ≥7) prostate cancer incidence. RESULTS: With a median (interquartile range) follow-up of 5.6 (1.8) years, there were 270, 148, and 88 cases of total, low-, and high-grade prostate cancers among African American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, <25 vs ≥35: hazard ratio [HR], 1.49 [95% CI, 0.95, 2.34]; P for trend = .03). Consequently, the risk associated with African American race increased from 28% (HR, 1.28 [95% CI, 0.91-1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38-2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, <25 vs ≥35: HR, 0.80 [95% CI, 0.58-1.09]; P for trend = .02) but positively associated with risk within African American men (BMI, <25 vs ≥35: HR, 2.22 [95% CI, 1.17-4.21]; P for trend = .05). Body mass index was positively associated with risk of high-grade prostate cancer in both non-Hispanic white men (BMI, <25 vs ≥35: HR, 1.33 [95% CI, 0.90-1.97]; P for trend = .01) and African American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, <25 vs ≥35: HR, 1.81 [95% CI, 0.79-4.11]; P for trend = .02). CONCLUSIONS AND RELEVANCE: Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men. SN - 2374-2445 UR - https://www.unboundmedicine.com/medline/citation/26181184/Difference_in_Association_of_Obesity_With_Prostate_Cancer_Risk_Between_US_African_American_and_Non_Hispanic_White_Men_in_the_Selenium_and_Vitamin_E_Cancer_Prevention_Trial__SELECT__ L2 - https://jamanetwork.com/journals/jamaoncology/fullarticle/10.1001/jamaoncol.2015.0513 DB - PRIME DP - Unbound Medicine ER -